CMS releases proposed 2026 payment updates for Medicare Advantage, Part D
The Centers for Medicare & Medicaid Services Jan. 10 proposed a 4.3% payment increase to Medicare Advantage plans for calendar year 2026, amounting to approximately $21 billion. CMS also proposed to complete its implementation of a three-year phase-in of changes to the MA risk adjustment model and growth rate calculation related to medical education costs in addition to other technical improvements. In addition, out-of-pocket prescription drug costs for individuals with Medicare Part D will be capped at $2,100 in 2026.
CMS is accepting comments through Feb. 10 on the advance notice of proposed changes. The agency expects to publish the final 2026 rate announcement by April 7.
Related News Articles
Headline
A new report from KFF reveals that Medicare Advantage enrollees had access to just 48% of the physicians available to Traditional Medicare beneficiaries in…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
A report by the Department of Health and Human Services Office of the Inspector General found that many Medicare Advantage and Medicaid managed care plans…
Headline
Medicare open enrollment for 2026 began Oct. 15 and runs through Dec. 7. During the annual enrollment period, Medicare-eligible individuals can check their…
Headline
The AHA Oct. 3 responded to the Medicare Payment Advisory Commission’s recent analysis on the financial impacts of Medicare Advantage enrollment growth on…
Headline
The Centers for Medicare & Medicaid Services Sept. 30 issued a memo, through the Health Plan Management system, finalizing the Medicare Advantage…